Letter to US Governors from HHS Secretary Xavier Becerra on Medicaid restatements

Letter to US Governors from HHS Secretary Xavier Becerra on Medicaid restatements

Dear Governor:

I am writing to follow up on my March 2023 letter regarding states’ efforts to return to pre-COVID-19 pandemic Medicaid operations. As full Medicaid renewals begin, it is of paramount importance to ensure that people do not lose coverage due solely to administrative processes. I urge you to take all the options we have offered to help eligible individuals and families maintain their health coverage during this process, and leverage all state partners to support individuals and families complete renewal forms.

High-quality health care coverage is a prerequisite for meaningful access to health care, something that provides peace of mind and security for every American family. The Department of Health and Human Services, through our Centers for Medicare and Medicaid Services, is closely monitoring changes in Medicaid and Children’s Health Insurance Program (CHIP) enrollment. I am deeply concerned about the number of people who lose coverage unnecessarily, especially those who appear to have lost coverage for avoidable reasons that state Medicaid offices have the power to prevent or mitigate.

Given the large number of people losing coverage due to administrative processes, I urge you to review the flexibilities currently in place in your states and consider going further to adopt the existing and new policy options we have offered to protect people and families eligible for procedural cessation. I’m happy to announce several new options that states may consider taking, such as allowing states to use their managed care plans to help beneficiaries complete these forms. These new options build on existing flexibilities we’ve already offered to states, such as:

  • Spread renewals for all populations over 12 months, which will provide more time to go through a smooth process and prevent systems from being backtracked. A smooth process reduces the burden not only on individuals and families, but also on state eligibility systems. Taking the time to go through the process correctly will ensure that those who are eligible for continued coverage do not experience a gap in care and that those who are no longer eligible transition easily to other sources of coverage.
  • Maximize the use of data sources, such as renewing people based on their eligibility for other programs, such as the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Families in Need (TANF). This will help reduce the need for some people to fill out and return a Medicaid renewal form.
  • Working with managed care plans and using data available from the US Postal Service to update people’s contact information so they actually receive the renewal forms that states are sending out.

These are just a few of the options that help maintain coverage for eligible people, there are many more, and we welcome the opportunity to provide technical assistance in implementing these policies.

A complete list of available state strategies can be found here.

In addition to these flexibilities, I encourage all states to work with stakeholders on the ground to engage more directly with Medicaid and CHIP families. A recent survey of Medicaid enrollees found that two-thirds of people weren’t sure their state was returning to normal Medicaid operations. We all need to do much more to ensure that everyone with Medicaid or CHIP coverage knows they need to check their mailbox and/or email for a renewal form and return it immediately to maintain their coverage.

I urge you to work with local governments, community-based organizations, schools, religious organizations and leaders, grocery stores, pharmacies, and anyone else in your communities who can help people understand the Medicaid renewal process and CHIP. We have innovative examples of this commitment across the country. For example, in Illinois, Chicago Public Schools provide direct assistance to families renewing their Medicaid and CHIP coverage, including sending information home with students and organizing community and outreach events.1 I’m calling for redoubling your efforts, expanding what works, and reaching even further to ensure that no eligible beneficiary experiences a loss of coverage that could have been avoided.

Any avoidable coverage loss is a concern, but I’m especially concerned that children may lose coverage because their parents don’t understand that even if they transition in coverage, their children are most likely still eligible for coverage through Medicaid or CHIP. HHS is committed to doing everything in its power to ensure our children have access to the care they need. Even if parents think they are no longer eligible, states should require parents to fill out renewal forms for their children anyway. We also encourage you to include messages about Medicaid renewals through schools, early childhood programs and summer camps to parents.

As you know, states must comply with federal rules regarding how they conduct Medicaid and CHIP renewals, and individuals must be afforded the due process they are entitled to in order for states to continue to receive more federal funding. We take our oversight responsibilities very seriously, and while we know that states are working hard to meet federal requirements, we will not hesitate to use the compliance authority provided by Congress, including requiring that states suspend procedural resolutions under conditions outlined by the Consolidated Appropriations Act, 2023, if needed.

As Secretary of Health and Human Services, I am committed to ensuring that every American has access to quality, affordable health care coverage. Our partnership is critical to making this a reality, and I urge every state to go above and beyond to keep eligible people covered. My team is ready to help.

Thank you for your continued cooperation.

Best regards,

Saverio Becerra

Closing notes

1Source: https://www.cps.edu/services-and-supports/health-and-wellness/connecting-to-medicaid-and-snap-cfbu/

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